August is Psoriasis Awareness Month, also known as Psoriasis Action Month. The recognition of this event is especially sweet this year as two novel non-steroidal topical medications for psoriasis, Zoryve® and Vtama®, have just received FDA approval, which had not happened in over twenty years! Dr. Jeffrey Sobell, a Boston-based renowned expert in the field of psoriasis, shares the basics on these two novel creams.
Both creams appear much more effective than the 2 long-standing steroid-free psoriasis creams, calcipotriene (Dovonex) and tazarotene (Tazorac). It is also exciting that thinning of the skin, a potential and concerning side effect of commonly used topical corticosteroids, is not seen with either cream. Consequently, there is no limit on the duration of use of these products.
Zoryve® (roflumilast cream 0.3%), approved for plaque and inverse* psoriasis in ages 12 years and older, targets inflammation by inhibiting PDE-4**. In two large pivotal studies, roughly 40% of subjects were clear or almost clear of psoriasis after 8 weeks of once daily application. Even higher success rates were seen when used for psoriasis in sensitive skin folds, namely under the arms, below the breasts or in the groin folds. In addition, most subjects have clinically meaningful improvements in itch. Zoryve® is well tolerated with a low rate of application site pain or reaction.
Vtama® (tapinarof cream 1%) is a novel small molecule TAMA***. Like Zoryve®, once daily application of Vtama® demonstrated reproducible and exciting results with 40% achieving clear or almost clear skin by week 12. Even more promising, remission is possible, with improvements lasting months after discontinuing therapy. The cream was well tolerated, with folliculitis and contact dermatitis occurring in a minority of subjects. Vtama® is indicated for adults with plaque psoriasis.
To help put this into context, we suggest coming in for a consultation with one of our skilled and trusted providers at SkinCare Physicians to discuss whether these new and exciting psoriasis treatment creams might be the right answer for you.
* Inverse psoriasis appears in skin folds where skin rubs against itself
** PDE-4: Phosphodiesterase-4
*** TAMA: Therapeutic aryl hydrocarbon receptor-modulating agent
(1) Photo courtesy of Medical News Today
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Can Vtama and Zoryve be used together? One in the AM and one in the PM?
Thanks for your message, but we don’t give medical advice on our blog. Please direct your question to the physician who prescribed your medication.
Can I continue to apply zoryve even if my psoriasis has cleared up?
Please contact the physician who prescribed your Zoryve. We do not give medical advice on the blog.
Have you had any patients continue to use Clobetasol once per day while using Vtama? I am having a psoriasis flare at the time I’m starting Vtama and my doctor thought it would be okay to use both at alternate times. I’m concerned about the skin being treated with both chemicals (even though 12 hours apart) and thought it might hinder Vtama’s desired effect on my skin. I would appreciate a second opinion. I am my doctor’s first patient to try Vtama.
We are sorry but we do not give medical advice on the blog.
can i use a moisturizer with Vtama?
Absolutely. I would apply the moisturizer first, followed afterwards by Vtama cream.
Can Zoryve cause acne, especially around chin & mouth/lips?
Acne was not a common side effect noted in the Zoryve clinical trials.
Can this cream be used on fingernails damaged by psoriasis?
Good question. It is an unknown. Only skin psoriasis was treated in the clinical studies for each medication, so we do not have any data for using either cream for psoriatic nail disease.
If using Zoryve on bottom of feet is it ok to cover your feet with socks
Absolutely!
Does this help with plaque psoriasis of hands and feet , it is thicker skin
Although palms and soles are typically more resistant to any treatment, both creams are appropriate to use in these locations.
Hello I recently started using the cream, can I use any serum with it ? Like I put the cream then my eyebrow serum ?
We recommend that you call the physician who prescribed the cream and diagnosed your condition.
Can you use it on your eyelids and right under your eye? My son has it directly below his bottom eyelashes.
Both creams are appropriate to use on any skin location, including eyelids and under the eyes.
Can you tell me if the Zoryve cream can be used on the scalp psoriasis? I am trying to determine this before I start treatment. My Dermatologist is unclear on this question. Thank you!
Yes, Zoryve is approved to treat psoriasis on any body location.
What can be used for the genital area in females?
Genital psoriasis is quite common. Both Zoryve and Vtama creams are appropriate options to use in this location. But as there are additional options, we suggest you consult with your dermatological provider.